PURPOSE: To analyze the risk of cardiovascular disease (CVD) after treatment of male germ cell cancer (GCC). METHODS: Clinical data were extracted from the Danish Testicular Cancer database. For each patient, 10 men matched on date of birth were identified in the Danish normal population by risk-set sampling. Cardiovascular risk factors, CVD, and associated deaths were identified in Danish registries. The association between treatment and outcomes was analyzed by separate Cox models for each outcome. Cancer treatment was included as a time-varying covariate. RESULTS: We included 5,185 patients with GCC and 51,850 men in the normal population. Median follow-up was 15.8 years. Treatment with bleomycin-etoposide-cisplatin (BEP; n = 1,819) was associated with increased risks of hypertension and hypercholesterolemia. Hazard ratios (HRs) of CVD < 1 year after initiation of BEP treatment were as follows: myocardial infarction (HR, 6.3; 95% CI, 2.9 to 13.9), cerebrovascular accident (HR, 6.0; 95% CI, 2.6 to 14.1), and venous thromboembolism (HR, 24.7; 95% CI, 14.0 to 43.6). One year after BEP treatment, the risk of CVD decreased to normal levels, but after 10 years, increasing risks were found for myocardial infarction (HR, 1.4; 95% CI, 1.0 to 2.0) and cardiovascular death (HR, 1.6; 95% CI, 1.0 to 2.5). Radiotherapy (n = 780) increased the risk of diabetes at long-term follow-up (HR, 1.4; 95% CI, 1.0 to 2.0) but not that of other outcomes. With surveillance (n = 3,332), cardiovascular risk factors, CVD, and cardiovascular death data were comparable to that of the normal population. CONCLUSION: Treatment with BEP was associated with highly increased risks of CVD < 1 year after treatment start and mildly increased risks after 10 years of follow-up. Radiotherapy increased the risk of diabetes but not incident CVD. The risk of CVD in patients followed in a surveillance program was comparable to that of the normal population.
PURPOSE: To analyze the risk of cardiovascular disease (CVD) after treatment of male germ cell cancer (GCC). METHODS: Clinical data were extracted from the Danish Testicular Cancer database. For each patient, 10 men matched on date of birth were identified in the Danish normal population by risk-set sampling. Cardiovascular risk factors, CVD, and associated deaths were identified in Danish registries. The association between treatment and outcomes was analyzed by separate Cox models for each outcome. Cancer treatment was included as a time-varying covariate. RESULTS: We included 5,185 patients with GCC and 51,850 men in the normal population. Median follow-up was 15.8 years. Treatment with bleomycin-etoposide-cisplatin (BEP; n = 1,819) was associated with increased risks of hypertension and hypercholesterolemia. Hazard ratios (HRs) of CVD < 1 year after initiation of BEP treatment were as follows: myocardial infarction (HR, 6.3; 95% CI, 2.9 to 13.9), cerebrovascular accident (HR, 6.0; 95% CI, 2.6 to 14.1), and venous thromboembolism (HR, 24.7; 95% CI, 14.0 to 43.6). One year after BEP treatment, the risk of CVD decreased to normal levels, but after 10 years, increasing risks were found for myocardial infarction (HR, 1.4; 95% CI, 1.0 to 2.0) and cardiovascular death (HR, 1.6; 95% CI, 1.0 to 2.5). Radiotherapy (n = 780) increased the risk of diabetes at long-term follow-up (HR, 1.4; 95% CI, 1.0 to 2.0) but not that of other outcomes. With surveillance (n = 3,332), cardiovascular risk factors, CVD, and cardiovascular death data were comparable to that of the normal population. CONCLUSION: Treatment with BEP was associated with highly increased risks of CVD < 1 year after treatment start and mildly increased risks after 10 years of follow-up. Radiotherapy increased the risk of diabetes but not incident CVD. The risk of CVD in patients followed in a surveillance program was comparable to that of the normal population.
Authors: Noa Shani Shrem; Lori Wood; Robert J Hamilton; Kopika Kuhathaas; Piotr Czaykowski; Matthew Roberts; Andrew Matthew; Jason P Izard; Peter Chung; Lucia Nappi; Jennifer Jones; Denis Soulières; Armen Aprikian; Nicholas Power; Christina Canil Journal: Can Urol Assoc J Date: 2022-08 Impact factor: 2.052
Authors: Andreas G Wibmer; Paul C Dinh; Lois B Travis; Carol Chen; Maria Bromberg; Junting Zheng; Marinela Capanu; Howard D Sesso; Darren R Feldman; Hebert Alberto Vargas Journal: JNCI Cancer Spectr Date: 2022-07-01
Authors: Christian D Fankhauser; Luca Afferi; Sean P Stroup; Nicholas R Rocco; Kathleen Olson; Aditya Bagrodia; Fady Baky; Walter Cazzaniga; Erik Mayer; David Nicol; Ekrem Islamoglu; Stephane de Vergie; Ragheed Saoud; Scott E Eggener; Sebastiano Nazzani; Nicola Nicolai; Lee Hugar; Wade J Sexton; Deliu-Victor Matei; Ottavio De Cobelli; Joseph Cheaib; Phillip M Pierorazio; James Porter; Thomas Hermanns; Robert J Hamilton; Andreas Hiester; Peter Albers; Noel Clarke; Agostino Mattei Journal: World J Urol Date: 2022-03-13 Impact factor: 4.226
Authors: Anders W Bjerring; Sophie D Fosså; Hege S Haugnes; Ragnhild Nome; Thomas M Stokke; Kristina H Haugaa; Cecilie E Kiserud; Thor Edvardsen; Sebastian I Sarvari Journal: Eur Heart J Cardiovasc Imaging Date: 2021-03-22 Impact factor: 9.130